Judith
L.
Ross, MD

Medical School

BA with High Honors, Wellesley College - 1972
MD, University of Chicago, Pritzker School of Medicine
- 1977

Residency

Children's Hospital of Philadelphia

Fellowship

National Institute of Health

Board Certification

Pediatric Endocrinology - 1983
American Academy of Pediatrics - 1982

Hospital Appointment

Thomas Jefferson University Hospital

Medical Licensure

New Jersey and Pennsylvania

Keywords

Estrogen and androgen appear to influence brain function in females at puberty. Environmental and cultural factors interact with the biological effects of estrogen and androgen on he brain an consequently on cognition and behavior. Women with Turner syndrome have dysgenetic ovaries that do not produce estrogen or androgen, before or at puberty. Therefore, Turner syndrome represents a unique, sex hormone-deficient, model in which to study the biological effects of androgen on cognition and behavior. The overall goal of this project is to study design we will study 1 two Turner syndrome groups: A androgen and B no androgen and 2 an age-matched, normal female control group. The specific aims of this project are to: 1 examine the effects of androgen on cognitive and social function in adolescent 11-13 years, growth hormone-treated girls with Turner syndrome, and 2 documented the differences and similarities in cognitive and behavioral function between adolescent Turner syndrome girls treated or not treated with androgen and age-andVIQ-girls treated with androgen, or not androgen-treated: 1 Turner syndrome girls treated with androgen versus no androgen will perform better on the tests of visual-spatial ability and visual-motor ability, 2 Turner syndrome girls treated with androgen versus no androgen will not perform differently on tests of attention, executive function, social function, and affective competence, 3 Turner girls treated with androgen for 2 years will demonstrate the greatest treatment effects, compared to girls treated for 1 year, and 4 androgen treatment will significantly reduce the differences between Turner syndrome and normal controls girls on tests executive function, social function, and affective competence. This investigation of adolescent cognitive and social development is an important step in understanding normal brain development. In addition, these data will determine how to optimize cognitive function in Turner syndrome, and will extend knowledge of the underlying mechanisms of sexual dimorphism.

Estrogen influences brain development in females at puberty. Environmental and cultural factors interact with the biological effects of estrogen on the brain and consequently on cognition and behavior. Women with Turner syndrome lack endogenous estrogen as a result of dysgenetic ovaries. Turner syndrome, therefore, represents a unique, estrogen- deficient model in which to study the biological effects of estrogen on cognition and behavior. The specific aims of this project are to: 1 to examine the differential effects of continuous estrogen replacement in early childhood on cognitive and social function in an ongoing, unique, randomized, double-blind, placebo-controlled, treatment trial. 2 document further, the cognitive differences between girls with Turner syndrome at ages 8 and 12 years versus age-matched, normal girls. Specifically, we hypothesize that estrogen replacement in early childhood will reduce the cognitive deficits of girls with Turner syndrome. In addition, we hypothesize that earlier age 5-7 years and longer estrogen replacement will result in less impairment of visual-spacial ability, visual-motorability, social function, and affective competence compared to later 9 to12 years estrogen replacement in girls with Turner syndrome. Finally, we hypothesize that the degree of social function in these girls will correlate with visual-spatial ability and facial recognition ability. The data generated from this carefully controlled biological investigation of cognitive and social development is an important stage in understanding normal brain development. In addition, these data will help determine how to optimize cognitive function in Turner syndrome, and will extend knowledge of the underlying mechanisms of sexual dimorphism.